DISABILITY CLAIMS UNDER INSURANCE POLICIES

Size: px
Start display at page:

Download "DISABILITY CLAIMS UNDER INSURANCE POLICIES"

Transcription

1 DISABILITY CLAIMS UNDER INSURANCE POLICIES This article by our legal contributor and Information & Referral Associate is to assist persons living with Parkinson s in making claims for disability benefits under insurance policies. You can make your own claim for disability benefits yourself, without hiring and paying a lawyer. Most claims are so made, and paid by insurance companies. The following guide tells you how. If denied previously, now, or later, you should seek out a lawyer experienced in disability claims; preferably with some knowledge of Parkinson's and its treatments. CONTENTS CLAIM PRIORITIES (Pg. 1) DISABILITY INSURANCE BENEFITS (Pg. 1) DISABILITY DEFINITIONS (Pg. 2) NOTICE OF CLAIM & PROOFS OF CLAIM (Pg. 2) 1) Notice of Claim (Pg. 2) 2) Proof of Claim (Pg. 3) i) Insured s and ii)your Physician s Proof of Claim Statements for; a) Parkinson s Disability Claim (Pg. 3) b) Parkinson s caused Psychological disorder Disability Claim (Pg. 4) iii) Employer s Proof of Claim Statement (Pg. 5) FAILURE TO GIVE NOTICE OR PROOF OF CLAIM (Pg. 5) PROOF OF CONTINUING DISABILITY (Pg. 6) 1 CLAIM PRIORITIES Two of the above forms should be started immediately, as they make the foundation for the rest: 1) Notice of Claim and 2) iii) Employer s Proof of Claim Statement. The Notice of Claim has a 30 day time limit. The Employer s Proof Claim gives you the job of obtaining your employer s periodic job reviews on your own performance. You will be searching out all statements recorded in your job reviews both before your illness and after your diagnosis. You are looking for anything which refers to you having a medical condition, and your declining output (productivity) until your last day at work. DISABILITY BENEFITS Benefits are defined in your insurance contract and invariably include payments for lost income calculated as a percentage of your salary, which may include bonus, or other remuneration. The exact calculation is determined by the wording of the insurance contract. Individual policies are delivered to you or copies available from your insurance agent or insurer. Group policies between your employer and the insurance company are rarely available.

2 Income tax is deductible if any premiums were paid by your employer, but not deducted if you paid all premiums. Disability payments available under CPP prior to age 65, and similar benefits may be deductible by your disability insurer. 1 DISABILITY DEFINITIONS There are two definitions of disability used in disability insurance policies: 1) you are not able to perform the duties of your own regular occupation because of your sickness or injury; or 2) you are not able to perform the duties of any gainful occupation for which you are reasonably suited by education, training or experience because of your sickness or injury. Insurance policies that use the first definition of your own job often revert to the second definition of any job after two or so years. The policy wording is the source of the definition used. As noted, policies are delivered to you or available from your insurance agent or insurer, but group policies between your employer and insurer are not generally so readily available. They generally include clauses designed to limit disability benefits that the insurer will contend reduces what it has to pay disabled employees. These may or may not apply or be enforceable. Employee handbooks and similar documents from your employer can be information sources but generally are not part of your policy; your contract of insurance. NOTICE OF CLAIM & PROOFS OF CLAIM Disability insurance policies invariably require that you communicate your claim in three ways; 1) an initial notice that you have a claim; 2) a proof of claim; one from you, another from your doctor, and a third from your employer, and 3) continuing proofs of disability, from you and usually your doctor periodically for the duration of your disability, until the insurance terminates usually at age 65. 1) Notice of Claim Written notice of the claim should be provided no later than 30 days from the date the claim arises; 1) to the insurer s head office; 2) by registered mail; 3) stating; i) the policy number, ii) the insured s name, iii) the nature of the injury or identity of the illness causing disability and iv) the date of first knowledge of the disability. It is prudent to send the notice as soon as possible 2, saving a copy of the notice, the envelope and the registered mail receipt, and to send notice even where the 30 day time limit is missed see section FAILURE TO GIVE NOTICE page Information on applying for and entitlement to CPP disability benefits is available on a number of web sites. 2 Some policies may stipulate time limits for filling less than 30 days from the date the claim arises

3 2) Proof of Claim The insurer, immediately upon receipt of a request, and not later than 15 days after receipt of Notice of Loss, should provide you with its proof of loss form to make your disability claim. As noted, your initial proof of claim will really be three separate written statements; one from you, another from your doctor and a third from your employer. Your doctor s proof of claim form is usually attached as the second part of yours, the insured s. It is wise to review your form with your doctor for accuracy and completeness, before finalizing it. Ask your doctor to complete his part and forward it to the insurer, but also provide you with a photocopy and note when it was mailed, for your records. Your employer s statement is usually done independently and sent to the insurer. i) Insured s and ii) Your Physician s Proof of Claim Statements a) Parkinson s Disability Claim; You can live well with Parkinson s for years. Parkinson s will progress at a different rate for each person. Accordingly, your type of work may not be affected for some years after your diagnosis. Your initial disability claim is made only if you become not able to perform the duties of your regular occupation because of Parkinson s. 3 Your own first proof of claim should include: the Parkinson s symptoms you have and their interference with your employment duties the progression of your Parkinson s experienced up to this point, noting the increased severity of symptoms any new symptoms as they have appeared that have led to your inability to continue your job duties the positive effect on your symptoms of medication & physiotherapy the negative effects, or side-effects of medication and therapy, e.g. dyskinesia It is wise to review your list of symptoms and their interference with what you do at work with your doctor, to assure accuracy and prepare him or her to complete the physician s statement proving disability. It is important to find a doctor who is knowledgeable about Parkinson s, ideally a neurologist specializing in Parkinson s. Patients can suffer one or more symptoms. Some of the most common are: Tremor Slowness Impaired balance Rigidity (stiffness) of the muscles Sleep disturbances Fatigue Soft speech; and/or slurred or garbled speech over time Problems with handwriting; reduction in handwriting size Stooped posture Cognitive Impairment; problem solving, task initiation, processing visual information, and memory Dyskinesia involuntary movements brought on by medication over the years 3 3 The same of course applies to any other disabling illness or injury.

4 It is important to note not just the impact of your symptoms on your job duties, but to also describe any impact that treatment and rehabilitative efforts (e.g. physiotherapy, speech therapy, group therapy, and prescribed exercise regimes) has on your work life. Specialist and therapist appointments are often difficult to schedule conveniently around working hours, and may in some instances require that a person book off a day off work, as it is not uncommon for specialists to be running well-behind scheduled appointments. Reduced working hours may be helpful in the sense of being able to accommodate certain needed treatment options; however, reduced working hours can harm an insured disability claim. Cutting back from 40 to 25 hours per week, for example, will lead many group insurers to assert that the base salary on which your disability income is calculated as a percentage is an annualized 25 hour per week wage; i.e. only 62.5% of your normal 40 hour per week wage. Accordingly, an express written amendment to your disability insurance is needed whereby the insurer agrees that your benefit is calculated on your 40 hour per week wage including inflation and any other adjustment already in the policy. b) Parkinson caused Psychological disorder Disability Claim; Psychological disorders brought on by Parkinson s can be causes of disability. Around 40% of Parkinson s patients experience anxiety disorder, clinical depression or related disorders. Worrying about Parkinson s progressive incurable symptoms and what it will mean for the rest of your life, job performance, and finances can also lead to anxiety or panic attacks. Your own first proof of claim should list not only the Parkinson s symptoms you have but also any additional symptoms of the Parkinson s induced psychological disorder. Interference with your employment duties caused by these symptoms individually or collectively should be described, as well as any positive treatment effect of medication, counseling, and psychotherapy. Some common anxiety and panic disorder symptoms are: Difficulty concentrating; progressing over time to periods of inability to comprehend written words repeatedly read Feeling restless; progressing over months and years to a need to flee confined spaces; offices, theatres, plane seating and so on Shortness of breath or smothering sensations Dizziness, unsteady feelings, or faintness Fear of dying Trembling, shaking, sweating or choking Palpitations or accelerated heart rate: many are taken to hospital emergency departments with symptoms of heart attack, followed by cardiac tests and examinations for heart disease. It is important to find a doctor who is knowledgeable about anxiety, and panic disorders, depression and related psychological disorders caused by Parkinson s; ideally a psychologist or psychiatrist. It is wise to review your list of symptoms and their interference with what you did at work with your doctor, to assure accuracy and prepare him or her to complete the physician s statement proving disability. 4

5 iii) Employer s Proof of Claim Statement Study your employment performance reviews. Find and include in your own Proof of loss Statement every accurate statement referring to you having a medical condition in these reviews of your job performance, and its deterioration until your last day at work. This will be doing the employer s job for your claim, but it is unlikely that the personnel department worker doing the employer s proof of loss will have the time to do this work indispensable to getting valid disability claims accepted and paid. Your performance reviews may be scattered through years of files. No one has the incentive you do nor has the knowledge of your Parkinson s to find what is in your employer s performance reviews showing the effect on your job performance. The definition of disability requires that you are not able to perform the duties of your regular occupation because of your Parkinson s or related psychological disorder. Your output (productivity) should have been in decline from after your symptoms became serious, until it fell to an unacceptably low level prior to the loss of your job. The goal is to establish a) your output before Parkinson s and to compare it to b) your output when you were terminated or had to quit because of disability. Your job performance reviews will likely have been given to you. If not, or if misplaced, ask your employer for copies, advising you need them for your disability claim. Aim to get them all. Return for missing ones politely until you have all the quarterly, bi-yearly or annual reviews. Review them from well before your Parkinson s diagnosis which will have started within your body well before you noticed symptoms. Study them thoroughly for your employer s first knowledge that you had a medical condition, and for all comments and numbers on your performance before and after from first to last. Deterioration in your job performance may have been minimized or omitted from your job performance reviews because of your long and faithful employment, prior good job performance, and sympathy for your problem. You are searching for just a few words or lines in dozens, maybe over a hundred pages. As noted above, include what you find in your own Proof of loss Statement, for your employer, and doctor, as well as the insurance company to see the claim you are making. No one else will do this for you. Your employer s files for you and your department, often voluminous, likely contain other observations or data relevant to your deteriorating performance as your disability progressed, but these are rarely available without denial of your claim and litigation. You want your claim acknowledged and paid without going to court. FAILURE TO GIVE NOTICE OR PROOF OF CLAIM There are short limitation periods after which it may be too late to start a lawsuit for a disability claim. Failure to give notice of claim within 30 days, or to furnish proof of claim within 90 days are said to invalidate the claim. Nonetheless such failures may be excused, if the notice or proof is given as soon as reasonably possible within one year from the date the claim arose, provided that it was not reasonably possible to give notice or furnish proof within the 30 and 90 day time limits. However, a disability claim that seems clearly too late for past wages can nonetheless still be valid to recover future earnings. 5

6 Disabilities like Parkinson s continue all our lives; until science provides a cure. This means that each and every day, a new day s claim is added to the prior day s claim. If, for example, you failed to make a claim after being diagnosed 5 years ago, and today is the 30th of this month, counting back from today s date, there are 30 days of disability for which a Notice of claim may still be in time, even though claims older than 30 days may be barred. The same applies for Claims within the above 90 day or 1 year periods. Moreover, an insurance company s statement denying a disability claim on grounds that are wrong, which are relied on by a person with a valid claim, who then lets the time limits expire, may still have a live claim. The reason is that the insurance company wrongly misled a person with a valid claim. PROOF OF CONTINUING DISABILITY With each benefit cheque, most insurers send a new proof of claim form and require new updated claimant s and physician s statements before sending the next cheque. Usually the insurer will inform the insured that the physician s charges for the forms are your responsibility. This is to continually revaluate the disability and treatments before approving payment of the next benefit cheque. Moreover, insurers may periodically require more detailed statements and reports from specialists seen by the insured, and, as a prerequisite of paying claims may require periodic examinations by medical specialists the insurer appoints. Failure to comply can be used by an insurer as grounds for terminating payments. Finally an Insurer may suspect a false claim or exaggerated symptoms and hire an investigator to monitor the claimant s activities and interview neighbours. The investigator may follow the claimant surreptitiously, taking notes as to his or her movements and recording her physical activities and capabilities by photograph and videotape. An investigators report can be used as grounds for terminating payments. Easily, these rights by accident or design can aggravate the pain and suffering of a person living with Parkinson s, particularly one suffering depression, anxiety, or panic attacks about his or her health or financial security. Insurers, employers and insureds invariably believe that insurance companies have a right to require any or all of the above and like terms reducing or stopping disability payments because of wording in a voluminous group policy document never seen or agreed to by the insured. This is not necessarily so. Apart from some terms and conditions made part of disability insurance policies by Ontario s Insurance Act, parties are otherwise not bound by contract terms which they have never seen and agreed to. Termination or reduction of disability payments by an insurer usually requires legal advice from a lawyer experienced in disability insurance, and Parkinson s symptoms and treatment. 6

Non-epileptic seizures

Non-epileptic seizures Non-epileptic seizures a short guide for patients and families Information for patients Department of Neurology Royal Hallamshire Hospital What are non-epileptic seizures? In a seizure people lose control

More information

INJURY LAW ALERT WINTER 2006/2007 ISSUE WHAT IS MEDICAL MALPRACTICE?

INJURY LAW ALERT WINTER 2006/2007 ISSUE WHAT IS MEDICAL MALPRACTICE? INJURY LAW ALERT WINTER 2006/2007 ISSUE WHAT IS MEDICAL MALPRACTICE? Medical malpractice is a broad term used to describe a number of different kinds of lawsuits brought against doctors and hospitals.

More information

Facts & Tips about Long-term Disability (LTD)

Facts & Tips about Long-term Disability (LTD) Facts & Tips about Long-term Disability (LTD) Revised June 2008 Please keep this document handy for reference It offers general information about LTD benefits under an insurance policy or contract. It

More information

MOTOR VEHICLE COLLISION SUMMARY ADVICE FORM

MOTOR VEHICLE COLLISION SUMMARY ADVICE FORM Form 1.03 July 9, 2014 MOTOR VEHICLE COLLISION SUMMARY ADVICE FORM TO: (Name) (Address) FROM: KUBITZ & COMPANY Lawyers 1716 10 th Avenue S.W. Calgary, Alberta T3C 0J8 (City, Province, Postal Code) Home

More information

Lewy body dementia Referral for a Diagnosis

Lewy body dementia Referral for a Diagnosis THE Lewy Body society The more people who know, the fewer people who suffer Lewy body dementia Referral for a Diagnosis Lewy Body Dementias REFERRAL FOR A DIAGNOSIS In the UK people with all forms of dementia

More information

Disability Claim Form Initial Request

Disability Claim Form Initial Request GROUP INSURANCE Disability Claim Form A partner you can trust. www.inalco.com According to your region, please submit the completed form to: Quebec All Other Provinces PO Box 790, Station B 522 University

More information

PERSONAL INJURIES. If needed, we may be able to tell you of professionals in your area whom you can consider.

PERSONAL INJURIES. If needed, we may be able to tell you of professionals in your area whom you can consider. PERSONAL INJURIES There are three main aspects to dealing with the results of personal injury: medical treatment, employment, and recovery of proper compensation. MEDICAL TREA TMEN T Coordinatinq Doctor

More information

LONG TERM CARE INSURANCE OUTLINE OF COVERAGE FOR EMPLOYEES OF. FLORIDA INSTITUTE OF TECHNOLOGY (the Sponsoring Organization)

LONG TERM CARE INSURANCE OUTLINE OF COVERAGE FOR EMPLOYEES OF. FLORIDA INSTITUTE OF TECHNOLOGY (the Sponsoring Organization) UNUM Life Insurance Company of America 2211 Congress Street Portland, Maine 04122 (207) 575-2211 LONG TERM CARE INSURANCE OUTLINE OF COVERAGE FOR EMPLOYEES OF FLORIDA INSTITUTE OF TECHNOLOGY (the Sponsoring

More information

Where to Begin 1. What You Need to Know Once You ve Been Injured 2. The People Playing a Role in Your Recovery 5

Where to Begin 1. What You Need to Know Once You ve Been Injured 2. The People Playing a Role in Your Recovery 5 Where to Begin 1 Contents What You Need to Know Once You ve Been Injured 2 The People Playing a Role in Your Recovery 5 Why You Need a Personal Injury Lawyer 8 Frequently Asked Questions 11 Recovery Diary

More information

Anna M. Trad, Ph.D., 1244 Clairmont Road, Suite 204 Decatur, GA 30030

Anna M. Trad, Ph.D., 1244 Clairmont Road, Suite 204 Decatur, GA 30030 Anna M. Trad, Ph.D., 1244 Clairmont Road, Suite 204 Decatur, GA 30030 PSYCHOLOGIST - PATIENT SERVICES AGREEMENT Welcome to my practice. This document (the Agreement) contains important information about

More information

DISABILITY CLAIM APPLICATION FORMS For Standard / Partial Payment and Dismemberment Plans

DISABILITY CLAIM APPLICATION FORMS For Standard / Partial Payment and Dismemberment Plans DISABILITY CLAIM APPLICATION FORMS For Standard / Partial Payment and Dismemberment Plans INSTRUCTIONS ALL OF THE FOLLOWING PROPERLY COMPLETED FORMS ARE ESSENTIAL TO THE PROMPT PROCESSING OF YOUR DISABILITY

More information

Michael Simpson, Ph.D. - Clinical Psychologist 954-217-3966 PATIENT INFORMATION

Michael Simpson, Ph.D. - Clinical Psychologist 954-217-3966 PATIENT INFORMATION Michael Simpson, Ph.D. - Clinical Psychologist 954-217-3966 PATIENT INFORMATION PLEASE PRINT CLEARLY DATE NAME ADDRESS DX (OFFICE USE ONLY) CITY STATE ZIP OCCUPATION HOME PHONE EMAIL WORK PHONE CELLULAR

More information

Steps to getting a diagnosis: Finding out if it s Alzheimer s Disease.

Steps to getting a diagnosis: Finding out if it s Alzheimer s Disease. Steps to getting a diagnosis: Finding out if it s Alzheimer s Disease. Memory loss and changes in mood and behavior are some signs that you or a family member may have Alzheimer s disease. If you have

More information

LONG-TERM DISABILITY BENEFITS

LONG-TERM DISABILITY BENEFITS LONG-TERM DISABILITY BENEFITS Revised September 1, 2004 No. 6 (*) 7000CI-U-EZ E O BENEFIT INFORMATION WHY LONG-TERM DISABILITY COVERAGE People tend to take their good health and ability to work for granted.

More information

DEALING WITH POLICE MISCONDUCT OR EXCESSIVE FORCE IN WISCONSIN

DEALING WITH POLICE MISCONDUCT OR EXCESSIVE FORCE IN WISCONSIN DEALING WITH POLICE MISCONDUCT OR EXCESSIVE FORCE IN WISCONSIN Written by: Jonathan S. Safran This guide attempts to answer some of the most common questions and provides a basic understanding of the steps

More information

Atlanta Center For Positive Change Karen Kallis, M.Ed., LAPC, NCC 333 Sandy Springs Circle, Atlanta, GA 30328

Atlanta Center For Positive Change Karen Kallis, M.Ed., LAPC, NCC 333 Sandy Springs Circle, Atlanta, GA 30328 Atlanta Center For Positive Change Karen Kallis, M.Ed., LAPC, NCC 333 Sandy Springs Circle, Atlanta, GA 30328 An important part of the helping relationship is understanding the expectations of the relationship.

More information

Dale C. Godby, Ph.D., ABPP, CGP 6330 LBJ Suite 150 Dallas, Texas 75240 972-233-0648

Dale C. Godby, Ph.D., ABPP, CGP 6330 LBJ Suite 150 Dallas, Texas 75240 972-233-0648 Dale C. Godby, Ph.D., ABPP, CGP 6330 LBJ Suite 150 Dallas, Texas 75240 972-233-0648 Problems in love and work, as well as troubling symptoms like depression and anxiety, often lead people to seek therapy.

More information

SAMPLE ONLY. TotalCare Max - Personal. Optional Benefit Appendix DISABILITY INCOME PROTECTION BENEFIT INDEMNITY

SAMPLE ONLY. TotalCare Max - Personal. Optional Benefit Appendix DISABILITY INCOME PROTECTION BENEFIT INDEMNITY TotalCare Max - Personal Optional Benefit Appendix DISABILITY INCOME PROTECTION BENEFIT INDEMNITY This appendix only applies if cover under the policy schedule includes the disability income protection

More information

Long-Term Disability A GUIDE TO YOUR INSURANCE CLAIM

Long-Term Disability A GUIDE TO YOUR INSURANCE CLAIM Long-Term Disability A GUIDE TO YOUR INSURANCE CLAIM CANTINI LAW GROUP ATLANTIC CANADA S INJURY LAWYERS Table of contents 3 Background information about LTD insurance What is LTD insurance? How is LTD

More information

Accident/Illness Claim

Accident/Illness Claim QBE INSURANCE (AUSTRALIA) LIMITED ABN 78 003 191 035 Accident/Illness Claim The issue of this form does not constitute an admission of liability on the part of the insurer. Please complete all sections.

More information

Motor Accidents Compensation Amendment (Claims and Dispute Resolution) Act 2007 No 95

Motor Accidents Compensation Amendment (Claims and Dispute Resolution) Act 2007 No 95 New South Wales Motor Accidents Compensation Amendment (Claims and Dispute Contents Page 1 Name of Act 2 2 Commencement 2 3 Amendment of Motor Accidents Compensation Act 1999 No 41 2 4 Amendment of other

More information

Claiming Disability Benefits. Application for Group Short Term Disability Benefits

Claiming Disability Benefits. Application for Group Short Term Disability Benefits Employee's Guide to Claiming Disability Benefits and Application for Group Short Term Disability Benefits RWAM DISABILITY MANAGEMENT A division of RWAM INSURANCE ADMINISTRATORS INC. RDM040.01.10 Employee's

More information

INITIAL ATTENDING PHYSICIAN S STATEMENT

INITIAL ATTENDING PHYSICIAN S STATEMENT INITIAL ATTENDING PHYSICIAN S STATEMENT Instructions to the Insured: Please complete, sign and date Section 1. Ask your physician to complete Section 2. Please note that you, the Insured, are responsible

More information

MOTOR VEHICLE COLLISION SUMMARY ADVICE FORM

MOTOR VEHICLE COLLISION SUMMARY ADVICE FORM MOTOR VEHICLE COLLISION SUMMARY ADVICE FORM Form 1.03 September 9, 2015 TO: (Name) (Address) FROM: KUBITZ & COMPANY Lawyers 1716 10 th Avenue S.W. Calgary, Alberta T3C 0J8 (City, Province, Postal Code)

More information

PARTNERING WITH YOUR DOCTOR:

PARTNERING WITH YOUR DOCTOR: PARTNERING WITH YOUR DOCTOR: A Guide for Persons with Memory Problems and Their Care Partners Alzheimer s Association Table of Contents PARTNERING WITH YOUR DOCTOR: When is Memory Loss a Problem? 2 What

More information

Clinical Negligence: A guide to making a claim

Clinical Negligence: A guide to making a claim : A guide to making a claim 2 Our guide to making a clinical negligence claim At Kingsley Napley, our guiding principle is to provide you with a dedicated client service and we aim to make the claims process

More information

Voluntary Long Term Disability Insurance FOR EMPLOYEES OF KENT STATE UNIVERSITY

Voluntary Long Term Disability Insurance FOR EMPLOYEES OF KENT STATE UNIVERSITY Voluntary Long Term Disability Insurance FOR EMPLOYEES OF KENT STATE UNIVERSITY Answers to your questions about coverage from Standard Insurance Company STANDARD INSURANCE COMPANY About This Booklet This

More information

Accident/Illness Claim

Accident/Illness Claim QBE INSURANCE (AUSTRALIA) LIMITED ABN 78 003 191 035 Accident/Illness Claim The issue of this form does not constitute an admission of liability on the part of the insurer. Please complete all sections

More information

A Member s Guide to Long Term Disability LTD

A Member s Guide to Long Term Disability LTD A Member s Guide to Long Term Disability LTD Elementary Teachers Federation of Ontario January 2012 Long Term Disability Whatever entitlement to benefits you have is based on the language of the Long Term

More information

HOW TO FILE A DISABILITY CLAIM (For Benefits Provided Pursuant to an Employer Provided Benefit Plan)

HOW TO FILE A DISABILITY CLAIM (For Benefits Provided Pursuant to an Employer Provided Benefit Plan) HOW TO FILE A DISABILITY CLAIM (For Benefits Provided Pursuant to an Employer Provided Benefit Plan) If you have Short Term Disability and/or Long Term Disability coverage by virtue of your employment,

More information

State Group Disability Income Plan Certificate. I. Benefits and Instructions

State Group Disability Income Plan Certificate. I. Benefits and Instructions State Group Disability Income Plan Certificate I. Benefits and Instructions A. Administration The State of Florida Group Disability Income Plan (Plan) is established pursuant to Section 110.123(3)(b) to

More information

(404) 919-9756 david@davidbrauns.com www.davidbrauns.com

(404) 919-9756 david@davidbrauns.com www.davidbrauns.com You are probably reading this guide because you were recently in an automobile accident. Now you are faced with some difficulties. The tasks of managing your care and your insurance claim can be confusing

More information

OFFICE POLICIES AND SERVICE AGREEMENT

OFFICE POLICIES AND SERVICE AGREEMENT Thomas Cicciarelli, Psy.D. PSY17298 350 Parnassus Avenue, Suite 601. San Francisco, CA 94117. 415-767-5199 OFFICE POLICIES AND SERVICE AGREEMENT Introduction Welcome to my practice. This document contains

More information

NOTICE OF PRIVACY PRACTICES UNIVERSITY OF CALIFORNIA DAVIS HEALTH SYSTEM

NOTICE OF PRIVACY PRACTICES UNIVERSITY OF CALIFORNIA DAVIS HEALTH SYSTEM NOTICE OF PRIVACY PRACTICES Effective Date: April 14, 2003 UNIVERSITY OF CALIFORNIA DAVIS HEALTH SYSTEM THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN

More information

DISABILITY INCOME PROTECTION BENEFIT INDEMNITY

DISABILITY INCOME PROTECTION BENEFIT INDEMNITY OPTIONAL BENEFIT APPENDIX TOTALCAREMAX Personal DISABILITY INCOME PROTECTION BENEFIT INDEMNITY This appendix only applies if cover under the policy schedule includes the Disability Income Protection Benefit

More information

Helpful Suggestions for Appealing a Denial of Benefits

Helpful Suggestions for Appealing a Denial of Benefits Helpful Suggestions for Appealing a Denial of Benefits This free ebook provided by: Law Offices of Tom Bush www.themilwaukeedisabilityattorney.com 161 W.Wisconsin Ave., Suite 5185 Milwaukee,WI 53203 800-772-1213

More information

PERSONAL ACCIDENT CLAIM FORM - MEMBERS

PERSONAL ACCIDENT CLAIM FORM - MEMBERS Pony Club Insurance Scheme PERSONAL ACCIDENT CLAIM FORM - MEMBERS Please read this page before completing the Claim Form Dear Member Thank you for your Claim Form request. This letter contains important

More information

SAMPLE ONLY. TotalCare Max Personal. Optional Benefit Appendix DISABILITY INCOME PROTECTION BENEFIT AGREED VALUE

SAMPLE ONLY. TotalCare Max Personal. Optional Benefit Appendix DISABILITY INCOME PROTECTION BENEFIT AGREED VALUE TotalCare Max Personal Optional Benefit Appendix DISABILITY INCOME PROTECTION BENEFIT AGREED VALUE This appendix only applies if cover under the policy schedule includes the disability income protection

More information

DETERMINATION IN TERMS OF SECTION 30M OF THE PENSION FUNDS ACT OF 1956

DETERMINATION IN TERMS OF SECTION 30M OF THE PENSION FUNDS ACT OF 1956 IN THE TRIBUNAL OF THE PENSION FUNDS ADJUDICATOR In the complaint between: M D Mthembu CASE NO.:PFA/KZN/499/00 Complainant and Iscor Limited Iscor Employees Provident Fund First respondent Second respondent

More information

LTD (Long Term Disability Plan)

LTD (Long Term Disability Plan) 1 LTD (Long Term Disability Plan) 2.1 Eligibility (a) (1) Regular full-time employees shall be covered by the Long Term Disability Plan upon completion of six months active employment with the Employer.

More information

Income Insurance LONG-TERM DISABILITY GALENA PARK. Enhanced (SSNRA/3Y) Disability Income Plan

Income Insurance LONG-TERM DISABILITY GALENA PARK. Enhanced (SSNRA/3Y) Disability Income Plan LONG-TERM DISABILITY Income Insurance Underwritten by: American Fidelity Assurance Company GALENA PARK Enhanced (SSNRA/3Y) Disability Income Plan Coverage Options Benefits Paid Directly to You Excellent

More information

Notice of Privacy Practices

Notice of Privacy Practices Notice of Privacy Practices THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. Privacy is a very

More information

Group Long Term Disability Insurance

Group Long Term Disability Insurance Group Long Term Disability Insurance For Active Members of New Mexico Public Schools Insurance Authority Answers To Your Questions About Coverage From Standard Insurance Company About This Booklet This

More information

New Jersey State Disability Claim. Your New Jersey State Disability Benefit Claim. How To Apply For Benefits

New Jersey State Disability Claim. Your New Jersey State Disability Benefit Claim. How To Apply For Benefits Your New Jersey State Disability Benefit Claim This packet contains the forms that will help us to process your claim for New Jersey State Disability Benefits. Please save a copy of this material for your

More information

Summary of New South Carolina Workers Compensation Laws For Injuries On or After July 1, 2007

Summary of New South Carolina Workers Compensation Laws For Injuries On or After July 1, 2007 Summary of New South Carolina Workers Compensation Laws For Injuries On or After July 1, 2007 Appeals o 1-23-600(D): Cuts out the Circuit Court chain of appeal. Appeals from the Full Commission go directly

More information

Voluntary Long Term Disability Insurance EMPLOYEES OF CITY OF NORFOLK

Voluntary Long Term Disability Insurance EMPLOYEES OF CITY OF NORFOLK Voluntary Long Term Disability Insurance EMPLOYEES OF CITY OF NORFOLK Answers to your questions about coverage from Standard Insurance Company STANDARD INSURANCE COMPANY About This Booklet This booklet

More information

HIPAA NOTICE OF PRIVACY PRACTICES

HIPAA NOTICE OF PRIVACY PRACTICES HIPAA NOTICE OF PRIVACY PRACTICES Marden Rehabilitation Associates, Inc. Marden Rehabilitation Associates of Ohio, Inc. Marden Rehabilitation Associates of West Virginia Health Care Plus Preferred Care

More information

Anxiety Disorders. What are anxiety disorders?

Anxiety Disorders. What are anxiety disorders? Anxiety Disorders What are anxiety disorders? Everyone knows what it's like to feel anxious-the "butterflies" in your stomach before that first date, the "jitters" before giving a speech, the sweaty palms

More information

Psychological support for adults living with HIV

Psychological support for adults living with HIV Psychological support for adults living with HIV Everyone living with HIV is entitled to specialist psychological support Although many people living with HIV do not have psychological problems, specialist

More information

Caring for depression

Caring for depression Caring for depression Aetna Health Connections SM Disease Management Program Get information. Get help. Get better. 21.05.300.1 B (6/08) Get back to being you How this guide can help you Having an ongoing

More information

Willamette University Long-Term Care Insurance Outline of Coverage

Willamette University Long-Term Care Insurance Outline of Coverage JOHN HANCOCK LIFE INSURANCE COMPANY Group Long-Term Care PO Box 111, Boston, MA 02117 Tel. No. 1-800-711-9407 (from within the United States) TTY 1-800-255-1808 for hearing impaired 1-617-572-0048 (from

More information

WORKERS COMPENSATION & YOUR RIGHTS

WORKERS COMPENSATION & YOUR RIGHTS WORKERS COMPENSATION & YOUR RIGHTS 655 Florida Grove Road Mailing Address P.O. Box 760 Woodbridge, NJ 07095 (732) 324-7600 GILL & CHAMAS Raymond A. Gill, Jr.* Peter Chamas* James Pagliuca Michael J. Hanus

More information

Total and Permanent Disability claim form

Total and Permanent Disability claim form Total and Permanent Disability claim form 1. Notice Of Claim Written notice of claim must be given to AXA Life within 90 days from the date of disability certified by a specialist in the relevant field.

More information

City of Los Angeles Disability Insurance Claim Packet Instructions

City of Los Angeles Disability Insurance Claim Packet Instructions Claim Packet Instructions Your Disability Benefit Claim This packet contains the forms necessary to apply for disability benefits. It also addresses common questions about Disability claims. Please save

More information

Group Benefits Plan Sponsor Statement Short Term Group Disability Claim

Group Benefits Plan Sponsor Statement Short Term Group Disability Claim Plan Sponsor Statement Short Term Group Disability Claim To be completed by the plan sponsor. Please print clearly and answer all questions. Please attach details on any additional that you believe should

More information

Buy-up Long Term Disability Insurance

Buy-up Long Term Disability Insurance Buy-up Long Term Disability Insurance For the employees of Montana University System Answers To Your Questions About Coverage From Standard Insurance Company About This Booklet This booklet is designed

More information

Disability Insurance Claim Packet Instructions. Your Disability Benefit Claim. How To Apply For Benefits

Disability Insurance Claim Packet Instructions. Your Disability Benefit Claim. How To Apply For Benefits Claim Packet Instructions Your Disability Benefit Claim This packet contains the forms necessary to apply for disability benefits. It also addresses common questions about Disability claims. Please save

More information

The Hospital Authority of Valdosta and Lowndes County dba South Georgia Medical Center

The Hospital Authority of Valdosta and Lowndes County dba South Georgia Medical Center LIFE INSURANCE COMPANY OF NORTH AMERICA 1601 CHESTNUT STREET GROUP POLICY PHILADELPHIA, PA 19192-2235 (800) 732-1603 TDD (800) 552-5744 A STOCK INSURANCE COMPANY POLICYHOLDER: POLICY NUMBER: The Hospital

More information

Canada Life Group Income Protection

Canada Life Group Income Protection Claim Form Important When an employee is absent from work due to an illness, we understand the value of an efficient and timely decision on a claim. We also aim to make the claim process as straightforward

More information

Disability Insurance Claim Packet Instructions. Your Disability Benefit Claim. How To Apply For Benefits

Disability Insurance Claim Packet Instructions. Your Disability Benefit Claim. How To Apply For Benefits Claim Packet Instructions Your Disability Benefit Claim This packet contains the forms necessary to apply for disability benefits. It also addresses common questions about Disability claims. Please save

More information

Personal Accident Claim Form

Personal Accident Claim Form Personal Accident Claim Form Claimant Details Title Full Name Date of Birth Occupation Usual Country of Domicile Claimant Address: Contact Details Postcode: Daytime Telephone: Email Address: Wherever possible

More information

Ontario Car Accident Insurance

Ontario Car Accident Insurance Ontario Car Accident Insurance Car Accident Insurance in Ontario I was injured in a car accident. What insurance is available to assist me as I recover? There are possibly two main sources of compensation

More information

Information for Worker s Compensation Clients

Information for Worker s Compensation Clients Information for Worker s Compensation Clients Overview of the Worker s Compensation Act Indiana Worker s Compensation cases are governed by a State law known as the Worker s Compensation Act. The legislature

More information

A GUIDE TO WORKERS COMPENSATION IN NEW YORK

A GUIDE TO WORKERS COMPENSATION IN NEW YORK A GUIDE TO WORKERS COMPENSATION IN NEW YORK If you live or work in New York State and suffer a work-related injury, illness or disability, you may be eligible for workers' compensation benefits. This summary

More information

Your Guide to Recovery

Your Guide to Recovery Your Guide to Recovery PERSONAL INJURY LAWYERS Committed to Your Future We will: Ensure all necessary notices are provided to maintain your claim and commence the action within the limitation period. Work

More information

Have you or someone you know suffered a personal injury? TIPS TO MAXIMIZE COMPENSATION

Have you or someone you know suffered a personal injury? TIPS TO MAXIMIZE COMPENSATION Have you or someone you know suffered a personal injury? TIPS TO MAXIMIZE COMPENSATION If you have suffered a personal injury it is important to consider all potential sources of compensation. A personal

More information

Depression & Multiple Sclerosis. Managing Specific Issues

Depression & Multiple Sclerosis. Managing Specific Issues Depression & Multiple Sclerosis Managing Specific Issues Feeling blue The words depressed and depression are used so casually in everyday conversation that their meaning has become murky. True depression

More information

What are Non-Epileptic Seizures?

What are Non-Epileptic Seizures? What are Non-Epileptic Seizures? What Is A Seizure? Cleveland Clinic Epilepsy Center Cleveland Clinic Epilepsy Center, established in 1978, is a national and international pacesetter in the treatment of

More information

Long-Term Disability Benefits: What You're Really Entitled to When Sick or Injured

Long-Term Disability Benefits: What You're Really Entitled to When Sick or Injured Legal Disclaimer This book is designed to provide information about the subject matter covered. It is provided with the understanding that the author and the publisher are not engaged in rendering legal,

More information

Income Protection Cover. Guide to making a claim

Income Protection Cover. Guide to making a claim Income Protection Cover Guide to making a claim Guide to making a claim Income Protection Cover What you ll find in this guide Page Understanding your Income Protection Cover 3 What do I do if I need to

More information

Accident/Illness Claim

Accident/Illness Claim QBE INSURANCE (AUSTRALIA) LIMITED ABN 78 003 191 035 Accident/Illness Claim The issue of this form does not constitute an admission of liability on the part of the insurer. Please complete all sections.

More information

Life Insurance Plan. for. Full-Time Appointed. Employees. IndianaUniversity. University Human Resource Services Effective January 1, 2004

Life Insurance Plan. for. Full-Time Appointed. Employees. IndianaUniversity. University Human Resource Services Effective January 1, 2004 Life Insurance Plan for Full-Time Appointed Employees of IndianaUniversity University Human Resource Services Effective January 1, 2004 This booklet is designed to summarize the group Life Insurance Plan

More information

Long-Term Disability Insurance

Long-Term Disability Insurance Long-Term Disability Insurance Developed for the employees of Pennsylvania State System of Higher Education Protecting Your Family Securing Your Future If you re physically healthy, you can work, play,

More information

A Student s Guide to Considering Medication for Depression or Anxiety

A Student s Guide to Considering Medication for Depression or Anxiety A Student s Guide to Considering Medication for Depression or Anxiety Real answers to your most important questions!! University!of!Missouri Kansas!City! Counseling!&!Testing!Center! 4825!Troost,!Suite!206!

More information

TIDELANDS COUNSELING CINDY STRICKLEN, M.S., I.M.F. LICENSE #61293 1411 Marsh Street Suite 105, San Luis Obispo, CA 93401

TIDELANDS COUNSELING CINDY STRICKLEN, M.S., I.M.F. LICENSE #61293 1411 Marsh Street Suite 105, San Luis Obispo, CA 93401 TIDELANDS COUNSELING CINDY STRICKLEN, M.S., I.M.F. LICENSE #61293 1411 Marsh Street Suite 105, San Luis Obispo, CA 93401 Minor Consent for Treatment and Service Agreement Welcome to Tidelands Counseling!

More information

Short-Term Disability

Short-Term Disability AMERICAN FIDELITY ASSURANCE COMPANY S Short-Term Disability Income Insurance Plan Designed Specifically For: Kansas Educators Plan Highlights s are paid directly to you, not to a doctor or your employer.

More information

Your Long-Term Care Insurance Benefits

Your Long-Term Care Insurance Benefits Long-Term Care Long-Term Care Insurance can help you or an eligible family member pay for costly Long-Term Care assistance when you can no longer function independently. For more information on See Page

More information

Long-Term Disability Insurance

Long-Term Disability Insurance Long-Term Disability Insurance Developed for the Employees of City of Colorado Springs (Employees with less than 5 years of PERA Service) (City Council Members) How This Program Protects You If you suffer

More information

PROCEDURES TO CLAIM SHORT TERM DISABILITY BENEFITS

PROCEDURES TO CLAIM SHORT TERM DISABILITY BENEFITS PROCEDURES TO CLAIM SHORT TERM DISABILITY BENEFITS The Short Term Disability (STD) benefits help you through periods when you are off work due to disability caused by illness or accidental injury outside

More information

First Notice of Claim for Illness or Injury

First Notice of Claim for Illness or Injury First Notice of Claim for Illness or Injury How to help us process your claim Checklist Before submitting your claim form, make sure you can tick all the boxes below: Illness or Injury claims - documents

More information

Expert Witness Services for Personal Injury Lawyers

Expert Witness Services for Personal Injury Lawyers Advanced Assessments Ltd Expert witnesses and Psychologists A Member of the Strategic Enterprise Group 180 Piccadilly, London, W1J 9HP T: 0845 130 5717 Expert Witness Services for Personal Injury Lawyers

More information

Personal Income Protection. support for the. unexpected. A Guide to Personal Income Protection

Personal Income Protection. support for the. unexpected. A Guide to Personal Income Protection Personal Income Protection support for the unexpected A Guide to Personal Income Protection Introducing ROYAL LONDON Ever since we started as a Friendly Society over 150 years ago, at Royal London we ve

More information

ProVider Plus Individual Disability Income Insurance

ProVider Plus Individual Disability Income Insurance ProVider Plus Individual Disability Income Insurance Keeping income strong Table of Contents Your income is your most valuable asset. Protect it!...........1 Disability Could it happen to you?........................2

More information

Group Life and/or Accident Coverage Disability Claim Form for Employee or Dependent

Group Life and/or Accident Coverage Disability Claim Form for Employee or Dependent Administered by: Group Life and/or Accident Coverage Disability Claim Form for Employee or Dependent IMPORTANT INSTRUCTIONS FOR COMPLETING CLAIM FORM(s) To the Employer/Employee, as applicable: We know

More information

Thomas J. Kibbie v. Killington/Pico Ski Resort (February 5, 2013) STATE OF VERMONT DEPARTMENT OF LABOR

Thomas J. Kibbie v. Killington/Pico Ski Resort (February 5, 2013) STATE OF VERMONT DEPARTMENT OF LABOR Thomas J. Kibbie v. Killington/Pico Ski Resort (February 5, 2013) STATE OF VERMONT DEPARTMENT OF LABOR Thomas J. Kibbie Opinion No. 03-13WC v. By: Jane Woodruff, Esq. Hearing Officer Killington/Pico Ski

More information

Accumulation Period A period of months that begins on the first day of disability and during which the Elimination period must be satisfied.

Accumulation Period A period of months that begins on the first day of disability and during which the Elimination period must be satisfied. Accumulation of Days of Disability In better disability policies, the Elimination Period days do not need to be consecutive. They may be accumulated, assuming each period of disability is not separated

More information

Long-Term Disability Insurance

Long-Term Disability Insurance Long-Term Disability Insurance Developed for the class 1 Employees of Research Triangle Institute Protecting Your Family Securing Your Future As long as you've got your health. If you're physically healthy,

More information

Maritime Injury Cases

Maritime Injury Cases Mailing Address: P.O. Box 34538 Seattle, WA 98124-1538 Maritime Injury Cases The following are the questions most frequently asked by our clients about Maritime injury cases. Obviously, the questions and

More information

Health & Safety The Compensation Fund 2013

Health & Safety The Compensation Fund 2013 The Compensation Fund provides compensation for workers who get hurt at work, or sick from diseases contracted at work, or for death as a result of these injuries or diseases. The Compensation Fund is

More information

Long Term Disability Insurance FOR EMPLOYEES OF THE UNIVERSITY OF NEW MEXICO

Long Term Disability Insurance FOR EMPLOYEES OF THE UNIVERSITY OF NEW MEXICO Long Term Disability Insurance FOR EMPLOYEES OF THE UNIVERSITY OF NEW MEXICO Answers to your questions about coverage from Standard Insurance Company STANDARD INSURANCE COMPANY About This Booklet This

More information

American Fidelity Assurance Company s. Long-Term Disability. Income Insurance. Plan Designed Specifically For: New Mexico Schools

American Fidelity Assurance Company s. Long-Term Disability. Income Insurance. Plan Designed Specifically For: New Mexico Schools American Fidelity Assurance Company s Long-Term Disability Income Insurance Plan Designed Specifically For: New Mexico Schools Why Do You Need Disability Income Protection? Disability causes nearly 50%

More information

INDEPENDENT BUSINESS ASSOCIATION

INDEPENDENT BUSINESS ASSOCIATION GROUP BENEFIT PLAN INDEPENDENT BUSINESS ASSOCIATION IBA TRUST Short Term Disability TABLE OF CONTENTS Group Short Term Disability Benefits PAGE CERTIFICATE OF INSURANCE... 2 SCHEDULE OF INSURANCE... 3

More information

Mental Disorders (Except initial PTSD and Eating Disorders) Examination

Mental Disorders (Except initial PTSD and Eating Disorders) Examination Mental Disorders (Except initial PTSD and Eating Disorders) Examination Name: Date of Exam: SSN: C-number: Place of Exam: The following health care providers can perform initial examinations for Mental

More information

James A. Purvis, Ph.D. Psychotherapy Services Agreement

James A. Purvis, Ph.D. Psychotherapy Services Agreement James A. Purvis, Ph.D. Psychotherapy Services Agreement PSYCHOLOGICAL SERVICES Psychotherapy is not easily described in general statements. It varies depending on the personalities of the psychologist

More information

Health Professionals who Support People Living with Dementia

Health Professionals who Support People Living with Dementia Clinical Access and Redesign Unit Health Professionals who Support People Living with Dementia (in alphabetical order) Health Professional Description Role in care of people with dementia Dieticians and

More information

Aflac Group Disability Advantage

Aflac Group Disability Advantage Aflac Group Disability Advantage INSURANCE PLAN 24-HOUR A disabling illness or injury may be unpredictable. We'll help make sure they don't affect your financial plans, too. AGC02074 4/13 AFLAC GROUP DISABILITY

More information

Beth Cerrito, Ph.D. Licensed Clinical Psychologist 1357 Monroe Avenue Phone: (585) 442-9601 Rochester, NY 14618 Fax: (585) 442-9606

Beth Cerrito, Ph.D. Licensed Clinical Psychologist 1357 Monroe Avenue Phone: (585) 442-9601 Rochester, NY 14618 Fax: (585) 442-9606 Beth Cerrito, Ph.D. Licensed Clinical Psychologist 1357 Monroe Avenue Phone: (585) 442-9601 Rochester, NY 14618 Fax: (585) 442-9606 CONSENT FOR EVALUATION AND TREATMENT Welcome to my practice. This document

More information

Benefits Handbook Date January 1, 2016. Basic Long Term Disability Marsh & McLennan Companies

Benefits Handbook Date January 1, 2016. Basic Long Term Disability Marsh & McLennan Companies Date January 1, 2016 Marsh & McLennan Companies This Plan provides you with income in case you can t work for an extended period of time because of an injury or illness. Benefits under Marsh & McLennan

More information

Voluntary Long Term Disability Insurance FOR GOVERNMENT OF THE DISTRICT OF COLUMBIA EMPLOYEES

Voluntary Long Term Disability Insurance FOR GOVERNMENT OF THE DISTRICT OF COLUMBIA EMPLOYEES Voluntary Long Term Disability Insurance FOR GOVERNMENT OF THE DISTRICT OF COLUMBIA EMPLOYEES Answers to your questions about coverage from Standard Insurance Company STANDARD INSURANCE COMPANY About This

More information

Depression & Multiple Sclerosis

Depression & Multiple Sclerosis Depression & Multiple Sclerosis Managing specific issues Aaron, diagnosed in 1995. The words depressed and depression are used so casually in everyday conversation that their meaning has become murky.

More information